Abstract: :
Purpose:Persistent hyperplastic primary vitreous or persistentfetal vasculature is a congenital anomaly caused by failureof the primary vitreous to regress. Past experience with itsmanagement usually yielded a poor visual outcome. The purposeof this study is to ascertain the various factors which impacton the final visual acuity.Methods:Twenty six patients seenbetween Aug 1972 and Dec 2000 were classified in a retrospecivestudy as having anterior PHPV, posterior PHPV or a combinationof both. Twenty-one patients had surgery (lensectomy, anteriorvitrectomy). All patients underwent amblyopia treatment. Visualacuity was determined to be good if it was better than 20/100or there was a central fixation on a target; vision was consideredto be poor if it was less than 20/100 or the fixation was inadequate.Compliance was evaluated for each patient (keeping appointments,judgment of the orthoptist...etc).Results:There were 26 patientswith 27 affected eyes. Fourteen eyes (51.85%) had poor visionranging from 20/200-HM (group1). In this group, 6 had an abnormalposterior pole, 9 underwent surgery, only 3 complied with occlusiontherapy, 5 developed glaucoma usually requiring surgical intervention,11 had strabismus and 8 had nystagmus. On the other hand, therewere 13 eyes (48.15%) with good vision in group2 (20/30-20/80).None of those had an abnormal posterior pole; all but one underwentsurgery and all complied with occlusion therapy. Only 2 developedglaucoma that has thus far responded to medical management.Eight & five patients developed strabismus and nystagmusrespectively.Conclusion:Poor visual outcome in patients withPHPV is associated with an abnormal posterior pole, a complicatedglaucoma and an inadequate compliance with occlusion therapy.Prompt surgical intervention and an adequate patching regimenusually yield a good visual result. The presence of strabismusor nystagmus does not necessarily preclude good vision.